Gallup polls have been asking some big picture questions about the major dimensions of health system performance–quality, coverage, costs and access–for nearly two decades now. This allows me to show you a long time series of trends that leave little doubt that despite many lofty promises made for Obamacare (or the high hopes of its proponents), Obamacare essentially left American health the same or worse on quality, coverage, costs and access . I found literally no evidence in these data that it made things better.